Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,024.10 / $5,168.10 / $8,883.96	Facility		$1,024.10	$5,168.10	$8,883.96
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $167.17 / $204.82 / $1,140.20	Facility	53	$167.17	$204.82	$1,140.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $383.36 / $631.82 / $4,005.42	Professional		$383.36	$631.82	$4,005.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,211.00 / $2,211.00 / $2,211.00	Facility		$2,211.00	$2,211.00	$2,211.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $613.62 / $1,221.35 / $6,114.58	Professional		$613.62	$1,221.35	$6,114.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $860.81 / $2,091.46 / $5,520.77	Professional		$860.81	$2,091.46	$5,520.77
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $562.89 / $898.39 / $4,436.07	Facility		$562.89	$898.39	$4,436.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $666.07 / $1,056.13 / $5,062.52	Professional		$666.07	$1,056.13	$5,062.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $688.41 / $2,904.81 / $4,576.10	Facility		$688.41	$2,904.81	$4,576.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $562.89 / $1,198.65 / $5,928.61	Facility		$562.89	$1,198.65	$5,928.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $769.49 / $1,360.37 / $5,928.61	Professional		$769.49	$1,360.37	$5,928.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $17,439.04 / $22,566.02 / $25,992.15	Facility		$17,439.04	$22,566.02	$25,992.15
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $776.08 / $1,413.75 / $6,284.90	Professional		$776.08	$1,413.75	$6,284.90
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $18,628.00 / $26,255.00	Facility		$3,028.00	$18,628.00	$26,255.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,221.37 / $3,521.69 / $5,965.06	Professional		$2,221.37	$3,521.69	$5,965.06